Electrode for diathermy treatments



July I c. vK. GIERINGER 2,404,283

ELECTRODE FOR DIATHERMY TREATMENTS Filed Jan. 17, 1942 2 Sheets-Sheet 1C. K. GIERINGER ELECTRODE FOR DIATHERMY TREATMENTS July 16, 1946.

2 Sheets-Sheet 2 Filed Jan. 17, 1942 ATTORNEY) Patented July 16, 1946ELECTRODE FOB DIATHERMY TBEATMEN Carl K. Gierlnger, Cincinnati, Ohio,assignor to The Liebel-Flarsheim Ohio, a corporation of Ohio ApplicationJanuary 17, 1942, Serial No. 427,101 3 Claims- (01. 128-413) Thisinvention relates to electrodes for therapeutic machines and it isdirected particularly to an electrode adapted especially to be usedindiathermic treatments.

The principal object of the invention has been to Provide an electrodewhich is capable of being adjusted to fit various body contours. In thepast, diathermy electrodes have been of three general types: pads andspaced plates, between which the patient is positioned; inductancecables or cords adapted to be wrapped or draped around the body memberto be treated; or inductance coils housed permanently within casings.High frequency energy applied to a patient from such latter typeelectrodes is transferred electromagnetically and varies in accordancewith the spacing of the electrodes from the body surface and electricalcharacteristics of tissue treated. It is sometimes desirable to locatethe electrodes as closely as possible to the surface to effect the mostefiicient transfer of the energy to the patient. However, it isimpossible, with electrodes of any of these types, to obtain the desiredpositioning of the electrode relative to the patient in the treatment ofbody areas where the contours are irregular so that eiilcient transferto patient can be made with a maximum degree of safety and convenience.Even the inductance cord, which is by far the most flexible of thethree, is inadequate for some conditions since it is diflicult to holdin place and most inconvenient to use.

Briefly, the present invention is directed to an electrode comprised ofat least two housings which are movable with respect to one another,with each containing an electrode conductor or electrode elementtherein. These separate housings or leaves are so arranged as to presentconcavely fashioned or trough-like surfaces with the troughs orlongitudinal axes of the concavities preferably extending in parallelrelationship to one another. By virtue of this configuration,

the leaves, upon adjustment, may be arranged so that the conflguratedfaces thereof conform.

Cincinnati,

When placed closely adjacent one another the leaves cooperate to definea tubular-like openin which is especially suitable for treating thewrist or ankle. The leaves also may be adjusted to unsymmetricalarrangements, thereby providing dissipating surfaces approximating thecontour of the front and back portions of the shoulder or the nape ofthe neck.

One of the chief advantages of the present apparatus is the ease'withwhich the doctor is enabled to arrange the electrodes relative to thepatient. For example, if, say, the wrist is to be treated the leaves aresimplyclosed over the wrist. In the treatment of the sacroiliac ordorsal regions the patient is placed in prone position and the leavesare spread to an open position and then rested upon the patient over theaiilicted area. It is also to be noted that the electrode may besupported upon an adjustable arm extending from the diathermy machine inthe usual manner. By rotating the electrode relative to the arm and byadjusting the arm to varying positions the electrode can be held infixed position during the course of a treatment, while the leaves are soarranged as to provide the most efficient arrangement for treatment ofthe given locality. In cases where an aillicted area is very sensitiveto the touch the electrode leaves may be arranged to conform closely tothe contour of the area and yet be spaced slightly out of contact withit: in the past this result has been impossible to obtain except wherethe areas are of such regularity as to be treated satisfactorily byspaced plates. when treatments requiring less than the full electrodeeflect are indicated, either one of the leaves may be usedindependentlyof the other, as in applying heat to the regions adjacentthe ear.

Short wave'energy is dissipated from these electrodes through conductorshoused within the leaves. In the preferred embodiment of the inventionthe conductors in each leaf are interconnected and cables, one taken toeach leaf, are connected with the respective conductor terminals. Thesecables provide flexible connections between the electrode and thediathermy machine.

From the electrical point of view it is preferable that the electrodeelements themselves contained within the housings be of theelectromagnetic kind, that is, coils of wire relatively supported in thehousings. However, in place of electromagnetic electrode elements,plates capable of furnishing capacitive effect may be employed ifdesirable. In the preferred structure the coils contained in the leafhousing are connected in series with one another whereby both areenergized simultaneously from cords leading from the diathermy machine.

Short wave energy of the type impressed across electrode conductors ofthe type utilized is potentially dangerous, and it is necessary that theutmost protection be provided against the leakage of current andshocking of the patient. The problem is aggravated by reason of the factthat the patient usually perspires to some degree, and the moistenedsurface of the tissue forms a good conductor.

To avoid these dangers it has been an object of the invention to providea structure in which the various portions of the electrode conductor areso interconnected as to be independently movable, yet well housed andinsulated against being accidentally contacted by the patient. In thisregard, the present invention contemplates an arrangement in which thecircuit in each electrode leaf is permanently mounted, with acommutating or flexible connector extending between the leaves tointerconnect the electrode portions contained therein.

A preferred embodiment of the present apparatus is illustrated in thedrawings, and from the foregoing description of the principles of theinvention and the detailed description which fol-= lows, those skilledin the art readily will comthe top and bottom walls being fashioned soas to interconnect the side walls 6 and form therewith a box forcontaining the electrode conductors; these are indicated generally at 9(Figures prehend the various modifications to which the improvement issusceptible.

In the drawings:

Figure l is a perspective view of an electrode constructed in accordancewith the invention.

Figure 2 is a rear elevation with the electrode shown in an openposition.

Figure 3 is a side View of the electrode.

Figure 4 is a sectional View showing the pivotal mounting of the leavesof the electrode.

Figure 5 is a View showing the leaves of the electrode in closedposition.

Figure 6 is a view showing the leaves in the open position.

Figure 7 is a view showing the leaves unsymmetrically arranged.

Figure 8 is a rear elevational view with the parts broken away to showthe mounting of the electrode conductors in the leaf housing.

Figure 9 is a sectional view taken on the line 9-9 of Figure 8.

Figure 10 is a sectional view taken on the line Ill-l0 of Figure 2.

Figures 11, 12 and 13 are views diagrammatically illustrating theapplication of the electrode to various portions of a patients body.

The electrode device shown in the drawing consists principally of a pairof leavesindicated generally at l which are pivotally mounted or hingedto a central panel indicated generally at 2, with current furnished totheelectrode, as for example, from a conventional short wave di athermymachine, through the cords 3-3 which enter the leaves at the rearwardportions thereof as shown in Figure 3. The cords 3 are pereferablyequipped with plug-in jacks (not shown) so that the electrode, as aunit, can be attached to or detached from the machine when desirable. Atthe rearward portion of the central panel 2 a clamp 4 is provided tofasten the electrode to a support arm 5 when a rigid mounting isdesired.

The leaves I and the central panel 2, as well as the other parts of theapparatus, are preferably constructed of a non-conducting plastic ma:-

8 and 9).

For enclosing the cavities within the electrode leaves they are providedwith back wall members H] which preferably are curved similarly to thecurvature of the faces 8. At the interior corners of the cavities bossesH are provided, both for reenforcement of the structure and forreceiving attachment screws I2 through which the back wall members I 0are fastened to the housings. It is desirable that the reenforcementportions of the casing terminate inwardly of the end and top and bottomwalls to permit theback cover to be recessed in the housing in flushrelationship with the rearward edges of the walls thereof.

Hinge members it extend outwardly from the side walls 6 of the housingsto provide for pivotal connection of the housings to the central panel2. Each housing is preferably equipped with two of these projections,one adjacent the top and one adjacent the bottom so that the centralpanel may be received therebetween.

The central panel 2 is preferably a box-like unit provided with the mainpivot means for the leaves at one end thereof, as indicated at M inFigure i and supplemental pivot means located at the other end thereofas indicated at l5. The electrical interconnection between theconductors in the leaves preferably is located at the end of the panelopposite the main pivots for the leaves and constitutes part of thesupplemental pivot means. In the preferred structure the panel 2consists of a face i6, side walls l'|-l'|,' an end wall l8 at one end,and a bridge wall H! at the other, interconnecting the side walls I! andspaced inwardly from the ends thereof.

At the main pivot connection M the projections or wings l3 extend towardone another from the corresponding side walls of the leaves and part wayacross the end wall l8 of the central panel 2. Friction washers 20 aredisposed between the end of the panel and the inner face of eachprojecting wing member.

On the other side of each projecting wing I3 similar washers 2! areprovided, and a strap 22 extends across these washers. Pivot screws23-23 pass through bores in the strap 22, the projecting wings l3 andthe end wall 18 of the central panel. These screws are-threaded into acompression plate 24 located in the interior cavity of the centralpanel. Compression springs are interposed respectively between the endwall ill of the central panel and washers 26 and these are thus pressedagainst the compression plate 24. The compression springs cause theinner face of the strap 22 and the outer face of the end wall ill to bepressed against the washers at the opposite faces of the projectingmem-- ber l3 to provide a frictional bearing of the surfaces against oneanother. It will be seen that by adjustment of the screws 23 the easewith which the leaves of the electrode are separated may be readilyadjusted, so that the electrodes remain in any position to which theymay be set by the operator.

Insulating caps 21 are mounted over the exposed heads of the screws II.The caps preferably are so constructed that they fit over the heads ofthe screws and snap into place on a spring washer provided imder eachscrew head; they may be pried loose for disassembly of the apparatus.

At the other end of the central panel the ends of the side walls I!thereof are spaced slightly from the inner faces of the projecting hingewings II, and conductor members II respectively pass through .theseclearance spaces along the inner faces of the members II. These membersemerge from the cavities of the electrode leaves wherein they areconnected with the conductors thereof as described at a later point inthe specification. Insulator strap 2! extends across the projectingmembers I! at the outer faces thereof and bolts 3| constituting thehinge pins at this end of the apparatus, pass through boresappropriately arranged in the strap 2!, the hinge members ii, the

conductor members 2! adjacent thereto, and through the bridge wall I! ofthe central panel.

An electrical connector Ii, having its opposite ends respectivelyjournalled on the pivot bolts 30, electrically bridges the connectormembers 28. This interconnecting member is housed in the cavity 32intermediate the end of the central panel and bridge wall l9.Compression spring members 33 which surround the pivot bolts 30, areinterposed between the cross wall I! and the connector piece ii to pressthe connector piece I toward the'conductor members 28. Washers 34, madeof conducting material, are located between the connector members andthe interconnector Ii. The bolts 3! are P ovided with nuts ll at theinner face of the bridge wall I! and the heads exposed at the strap 29are provided with insulating caps 31, as previously described.

In the preferred structure the ends of the pro- Jecting wings I! are ofrounded configuration so as not to obstruct one another during pivotalmovement of the leaves, andat the end of the central panel to which theelectrical interconnection I! is arranged, the insulator strap 29 isprovided with a protrusion II on its inner surface, configurated to fitwithin the nip constituted by the rounded edges of the projectingmembers ll,

so as to obstruct this passageway and prevent accidental contact frombeing made with the connector ll. 7 I

A cover plate fits over the back portion of the central panel and overthe cavity portion 32. The cover plate is fastened by means of screwsengaging tapped holes provided in the bosses 38.

The arrangement and mounting of the electrodes in the cavities of thehinged leaves is shown best in Figures 8 and 9. Cords 3 enter the backwalb ll of the housings at the central portions thereof. Within eachcavity each electrode conductor therefor has its one end fastenedelectrlcally to the cord. From thispoint each conductor passes spirally,though preferably in a somewhat rectangular arrangement, to itsconducting member 28.

In the preferred structure the back wall member ll of each housing isprovided with bosses 40 having threaded studs ll projecting therefrom.

Insulator posts 42 are threaded onto the studs and project forwardlyfrom the inner face of the back wall member. At the top of each post aconnection is provided; this unit preferably is a split or forkedprojection having arms arranged to straddle the electrode conductor andso that the conductorcan be 1 tened in place as, for example, bysoldering. Posts 42 provide firm support for the fiat spiral-like coiledarrangement in which the electrode is wound. It is desirable to arrangethe coils 9 within the housings in such manner that they are spacedslightly from the dissipating faces T thereof; the intervening layer ofair acts as an insulator to prevent sparking even when the drums are incontact with moist or wet tissue.

The two posts 42 are arranged at opposite sides of the opening in theback wall il through which the cord 3 passes and a metallic strap 43 isrigidly fastened across these members. This strap is provided with acentral aperture and the bared end of the conductor within the cable 3is inserted through the opening, bent over and soldered to-the strap,while the electrode conductor 9 is fastened to a split lock extendingfrom one of the posts. It is also desirable, as shown particularly inFigure 9, to fasten a relatively stiff wire member to the connectingstrap 43 and wrap the depending end of this wire around the insulationof the cable 3 so as to prevent the cable from becoming detached. Inthis manner the insulation of the cable is held securely to the housingand the electrode conductor therein is relieved of the mechanicalstrains to which the cable is subjected during normal usage thereof.Each of the other ends of the electrode conductors is bent downwardlyrespectively to engage the connector members 28 and the connectionbetween the two is made by wrapping the connector strap 28 around theelectrode wire and soldering the two together.

In the preferred structure the flat coil arrangement into which .each'electrode is wound, is curved convexly in order that it be spacedevenlyfrom the dissipating face of each electrode leaf over its entiresurface. This provides a uniform field of distribution of diathermicenergy. Itis desirable to wind the coils in the housings in suchdirections that the fields produced by them are additive. The arrowsshown along the coil windings in Figure 8 illustrate the preferredarrangement. It will be seen that current in the coil windings at theright hand side of the right hand coil is moving in the same directionas current in the left hand side of the coil 'in the left hand housing.These currents therefore cooperate with one another to produce a fieldof very high intensity when the leaves are facing or partially facingone another, as when the leaves are in'a closed position as shown inFigure 5. This field of high intensity is particularly useful intreating body extremities such as the hands or wrists which heretoforehave been always very difllcult to treat'because of the relatively smallmass that they offer.

When the leaves are in the open position there is relatively littlecoupling between the coils in the respective leaves and the field ofeach is not appreciably affected by the field of the other. Thus,considering the field produced by each coil independently of the otheras'unity, it will be seen that when the leaves are arranged in the wideopen position the total field has a relative value of approximately 2,while the total field approaches 4 when the leaves face one another andthe windings are arranged for mutual cooperation. The high intensityfield produced by this arrangement permits sufiicient treatment to begiven to small body areas; in the treatment of the larger body areas,such as the chest or abdomen, the coupling between the patient andamazes the electrode is such that the field need not be of such highintensity.

From the electrical connections which have been described it will beseen that a circuit through the complete electrode is constitutedthrough the cord 3 entering one leaf, through the electrode contained inthat leaf, through the commutating connector member 28 emerging fromthat leaf to the interconnecting strap 3!, thence through the otherconnector member 23 entering the other leaf, through the electrodecontained in that leaf and out th cord 3.

The entrance of the cords through the back of the electrode leaves isdesirable for several reasons. The cords do not interfere with thepositioning of the electrode upon the body and in this positionattachment of the electrodes in the leaves to the cords is easilyeffected. However, in place of the structure shown, it is to be observedthat the cords may be connected to the electrodes at other points, asfor example, through the top or bottom or outer side walls, and alsothat the circuits in the leaves may be independent of one another.

In many diathermy treatments it isdesirable to position the electrodesstationarily with respect to the patient, as when contact of theelectrode with the patient is to be avoided. For this purpose thediathermy machines may be equipped with suitable adjustable supportarms. To fasten the electrodes ofthe present invention to such supportmembers a clamp ring is provided at the back part of the central panel2, as indicated at 4. This unit is comprised of a base piece dd having apair of upstanding arms tit-45. A split ring 46 is carried by these armsand it is equipped with outwardly extending tangs til-M oppositelyarranged. A bolt 48 passes through these tangs and threadedly carries alock nut 49. By adjustment of the lock nut the diameter of the splitring can be varied so that when the ring is inserted over the end of thesupport arm, as indicated at 50 in Figure 11, the lock nut can betightened to clamp the ring to the support arm.

A washer 5| rests on the inner face of the base piece 44 of theattachment device which in turn rests on a washer 52 positioned betweenit and the back of the central panel 2. A bolt 53 passes through the cup5i, the base piece M and washer 52 and through a bore in the bacl; plateof the panel 2 to rotatively journal the clamping unit to the panel. Atthe inner face of the back. plate friction means is provided forcontrolling the rotation of the clamp piece with respect to the panel.Bolt 53 passes through a washer 5d at the inner face of the back plateand also through a pair of interlocking washers 55 and 5&5 which areseparated by a cup spring. The cup spring has slots cut in its peripheryand tangs are struck from 8 the washers arranged at opposite sides 0! itso as to vfit within the slots, thereby holding the spring innon-rotatable relationship with the washers. A nut 51 which preferablyis welded to the washer 56 is threaded on the inner end of the bolt 53,with the nut being tightened until the desired friction is attained andthen being pinned to the bolt. As will be seen, the cup-compressedspring draws all of the parts together to provide the desired friction.

Figures 5, 6 and '7 show various positions to which the leaves of theelectrode may be moved and Figures 11, 12 and 13 show practicalapplications of the apparatus. The types of treatment shown in theselatter illustrations, especially Figure 12, are difiicult, if notimpossible, to conduct satisfactorily with electrodes of the typeheretofore available, whereas such treatments prising housing membershaving cavities-therein and being hinged together, respective portionsof an inductive electrode coiled and housed in each housing member, andan electrical interconnection between the respective electrode portionscontained Within said housings, each housing having an electrode facewhich is curved convexly, and with the coiled conductor portions in saidhousings being configurated to conform to the curved faces thereof.

3. Apparatus adapted to be used in diathermic treatments comprising apair of insulating housings, at least one of which presents atroughshaped face, inductive electrode conductor means contained in theform 'of coils within said housings for dissipating diathermic energytherefrom, means for applying diathermic current to said conductormeans, the housings being pivotally interconnected with one another on apivotal axis parallel with the trough-shaped concavity in the said oneof said housings, and the coiled conductor which is contained in thehousings having the trough shaped face being configurated to conformsubstantially to the curvature of said face.

CARL K. GIERINGER.

